As the first joint World Health Summit with the World Health Organization convenes in Berlin from Oct. 16-18, political and health leaders should openly confront the powerful influence of nonstate actors such as the profit-driven pharmaceutical industry, the Bill & Melinda Gates Foundation, and McKinsey Consulting in shaping global health.
While certain sessions at the WHS consider the fragmentation of the global health architecture, there appears to be no interrogation of the influential role of the pharmaceutical industry, its corporate consultants, or philanthropy in engineering global health outcomes.
Pharma monopolies continue to shape COVID-19 vaccine access and played a particularly devastating role in contributing to vaccine apartheid. And while the 2008 Human Rights Guidelines for Pharmaceutical Companies issued by the United Nations special rapporteur on the right to health provide helpful recommendations for advancing access to medicines, these guidelines are largely ignored.
This is because the global health architecture is primarily shaped by Euro-American states that reinforce the power of the profit-driven pharma industry, and nonstate actors such as Gates and McKinsey.
Chatham House defines the global health architecture as comprising “actors working transnationally with a primary intent to improve health.” A 2015 Chatham House study maps 203 global health groups, of which, more than 90% are headquartered in the United States and Europe. The anchoring of the global health blueprint in Euro-American states perpetuates colonial hierarchies and advances an ideological orientation to health informed by capitalist logic.
Despite WHO being the primary international agency in global health, nonstate actors such as pharmaceutical companies that refuse to share intellectual property around COVID-19 vaccines are now at the center of the health system, exerting power and influence over vaccine access, but also shaping the trajectory of current and future pandemics.
Large donors such as the Gates Foundation, have aided this profit-centered approach to global health by initially failing to support intellectual property waivers that would allow the COVID-19 vaccine recipe to be shared in time to save millions of lives.
Both Bill Gates and Gates Foundation CEO Mark Suzman were on stage at the opening ceremony of the WHS. That the Gates Foundation is the only institution with more than one speaker once again reinforces the outsized influence of undemocratic and unaccountable groups in the global health space.
The WHS needs to confront the unbridled power and influence of nonstate actors in shaping the global health architecture and must instead advance a human rights-centered global health order that ensures the full realization of the right to health for everyone.
If the COVID-19 pandemic teaches us anything, it’s that we cannot assume the benevolence of nonstate and private sector actors as their choices continue to deal a deadly blow to basic rights.